外源性胆红素在缺血性急性肾衰竭中的作用

Effect of Bilirubin on Ischemic Acute Renal Failure

目的观察外源性胆红素对缺血性急性肾衰竭(IARF)时血清中肝细胞生长因子表达、肾功能及其肾组织病理学改变的影响,探索外源性胆红素对急性肾衰竭保护作用。方法选取健康雄性大鼠30只,随机分为3组(观察组、假手术组、对照组),每组10只,建立肾缺血急性肾衰竭模型,观察组术前3 d连续给予胆红素5μmol,1次/d,其他各组同期给予等容积生理盐水,于IARF后4 h、12 h测量各组血清中尿素氮、肌酐及其肝细胞生长因子表达情况及其肾组织病理学改变。结果 IARF 4 h后观察组血清HGF水平较对照组、假手术组明显升高(P<0.01),对照组与假手术组之间无显著差异(P>0.05);IARF 12 h后血清HGF对照组表达水平高于观察组、假手术组(P<0.05),在对照组中HGF在IARF 12 h的表达水平高于IARF4 h的表达(P<0.01);观察组血清BUN、Cr水平均较对照组显著降低(P<0.05),观察组与对照组血清BUN、Cr水平均高于假手术组(P<0.01),肾组织损害程度对照组低于观察组。结论外源性胆红素能够减轻肾损伤,改善肾功能,而外源性胆红素使肝细胞生长因子表达上调,可能是其减轻肾损伤机制之一。

Objective To investigate the effect of Bilirubin on the serum levels of hepatocyte growth factor,renal function and the damage of renal morphology in ischemie acute renal failure（IARF）,and to study the protective mechanism of Bilirubin in IARF.Methods Selecting 40 health male rats and randomly dividing them into 3 groups（observation group,sham-operated group and control group）.Establishing renal ischemia acute renal failure model.The rats in observation group were pretreated with Bilirubin for 3 days,and others were given physiological saline.Biochemical parameters for serum HGF,blood urea nitrogen（BUN）,creatinine（Cr）were measured and renal tissue pathology changed.Results After 4 hours IARF,HGF level in observation group is higher than sham-operated group and control group（P0.01）,and there is no difference between sham-operated group and control group（P0.05）,the expression level of HGF of IARF 12 hours is higher than IARF 4 hours in control group（P0.01）.Blood urea nitrogen（BUN） and creatinine（Cr） in observation group are lower than that in the control group（P0.05）,control group observation group is higher than sham-operated group（P0.01）.The renal tissue damage of control group is lower than the observation group.Conclusion Bilirubin pretreatment can alleviate the damage of renal function in IARF and Bilirubin can induce the expression of HGF.